mayoraasei: (OTZ)
So...remember how I said not long ago that I wanted to watch this so I had something to laugh about?

...Remember how I kept screaming at JIN for the ridiculous "medicine"...Yeah, I should have. I really should stop watching medical dramas, now.

As a drama Doctor X isn't bad, although I'm not a huge fan of Yonekura's wide-eyed mostly expressionless acting, but at least she is at the respectable age to play a freelancing surgeon.

I like me some drama that prods gentle fun not only at the widely-accepted ridiculous Japanese working hours (i.e. 9-5 plus all hours before midnight), but also at the widely-accepted ridiculous surgical working hours (i.e. 7-4 plus all hours before...well, 7am the next day).

I also enjoy a character who is pragmatic and brisk - which is what surgeons are all about, after all - who cares not a flying donkey about the rigid ridiculous ritualistic schedule that define a prestigious hospital's working life, including the hilariously familiar 25-peopled ward rounds led by the well-weathered director and trailed by a troop of forcefully alert faces.

That said, while she's free to fight for her own working rights, there are bits about her "rules" that make for good drama but for terrible medical practice.

Her refusal to participate in daily rounds on the basis that "you don't need a medical degree to go on rounds" is ridiculous. Sure, every surgeon hates rounds, that's why they do surgery, but isn't she even going to check out her patients after surgery?

In fact, the first time she brought up the "you don't need a medical degree" argument (for paperwork) it was a laugh, but the fourth and fifth time it really began to irk me. Her refusal to shake the director's hand citing that exact reason really clinched it for me. You don't need a medical degree to eat lunch, do you? Getting a medical...ahem, even a SURGICAL qualification doesn't excuse you from human decency and basic courtesy.

And other bit that really pissed me off cracked me up was when the patient went into clear shock on the operating table, the anaesthetist sat there swinging her legs for 15 bloody minutes until Daimon got changed and scrubbed and gowned and gloved, and THEN said "GIVE SOME ADRENALINE".

OMFG You're a bloody anaesthetist! Not a scrub nurse!!! YOU'RE the one managing the ABC's. WHY THE FRICK were you waiting for the SURGEON'S instructions???? You're the one the surgeons turn to when shit hits the fan during surgery, especially when that shit is a systolic BP of 60!!!

At this point I don't think it's even worth mentioning that they pushed 10mL of adrenaline through via a peripheral intravenous line. PALM. MEET FACE. (Unless, of course, the anaesthetist had the foresight to make up the 1:100,000 solution, which I can't find any reliable guidelines to say you can/can't give it as a bolus)
mayoraasei: There is no such thing as coincidence (Default)
So I'm reading up a bit about gout and the different mechanisms by which colchicine and allopurinol treat gout (yes, yes, I know I have no more exams and it's a wonder I don't know these things but somehow managed to pass anyway).

Allopurinol is easy enough to understand, but when I got to colchicine, it said this, "At micromolar concentrations, it suppresses monosodium urate crystal-induced NACHT-LRR-PYD-containing protein-3 (NALP3) inflammasome-driven caspase-1 activation"

I think my brain died somewhere after the word "crystal".



*Goes to sleep*


BTW Japanese film festival tickets go up tomorrow. I'm gonna order early in case Gantz sells out, so lemme know, people!

so

6 Oct 2011 10:52 pm
mayoraasei: There is no such thing as coincidence (Default)
To-morrow, and to-morrow, and to-morrow,
Creeps in this petty pace from day to day,
To the last syllable of recorded time;
And all our yesterdays have lighted fools
The way to dusty death. Out, out, brief candle!
Life's but a walking shadow, a poor player,
That struts and frets his hour upon the stage,
And then is heard no more. It is a tale
Told by an idiot, full of sound and fury,
Signifying nothing.


Isn't this beautiful? Makes me want to go read Hamlet again. Because I can.

BECAUSE.

I passed!!!!!!!!!!!!!!!!!!!!!!!!!!!

*Awaits round of applause*

So until the time I decide to get onto a training program, which may well be 2 to many years away (hope not the latter) I AM FREEEEEEEEEE. Well, I am now enslaved by NSW Health but at least I can rearrange my bookshelf to look neat for a couple of weeks. LOL.

I realised I have spent 8 years in the University of Sydney. This is the longest stint I have ever stayed in any institution =0=;;;;;;

I now have all this paperwork to fill in and insurance to buy and unions to join and affairs to set in order.

I still have an 8 week term left before graduating but there are no immediate exams on the horizon, only painful EBMs and more paperwork.

To be honest I didn't feel very apprehensive (or sad, upon my heartless soul, or soulless heart) when I left high school for university. To me I didn't anticipate the environment being much different and I think in many ways that was true. The world got larger but you're still just as protected.

But I think this time I am a bit nervous, for a combination of reasons. I don't feel I know as much as I should, and certainly not as much as I can. There are suddenly real responsibilities, even if not a lot, and with enough safety netting to truss you up before you actually faceplant the ground. And I'll be at a new hospital where I'm unfamiliar with expectations because they train UNSW students, who in my pink idealised vision all have anatomy coming out of their ears, or that's what our rheumatologist said XD

Have I learned enough in four years? I feel like I've forgotten more of my medical science than I've picked up on the clinical. I used to remember the complement cascade! I used to be able to name you 8 different receptors and cytokines coming out of a T cell! I used to know the exact mechanism of antibody selection! I used to know what plate to culture a Staphylococcus on as opposed to an enterobacter!

I used to think I have good memory but now I think I need to upgrade all my hardware, starting with RAM, which may allow me to multitask more than what is humanly achievable in 24 hours. Wouldn't be lovely to use all that waiting around for late clinicians time for sleeping? Perhaps humans will evolve into a species that survives on microsleep.

Sometimes I feel EBM is driving the medical field towards too much protocols and guidelines. But maybe that's all we need. Maybe one day all we need is a sophisticated AI that can map differential diagnoses according to a survey of patient history, that can do cursory examination and investigations, then draw from known likelihood ratios what the likely diagnosis is. I have a feeling that the success is probably not going to be much different to a trained human. Maybe health will run like a factory. Patients are conveyor-belted from machine to machine for the appropriate imaging and blood tests. And they leave with a print out with their diagnosis and a packet of personalised pills.

Ah the future, how glad I am I do not live there. LOL.

Gosh there are so many movies on the Japanese Film Festival I want to see this year. Gantz 1 and 2, Arrietty, the funny-looking Takenouchi (the boss of Boss in Boss) and Mizukawa one, and maybe even Akunin.

I am so 'rupt.
mayoraasei: (Angry)
From all these ridiculous articles I cannot resist clicking on.

Depression? Don't believe it

Literally that is its title.

And it starts out with...

In 2000 the World Health Organisation named depression as the fourth leading contributor to the global burden of disease and predicted that by 2020 it would rise to second place. I suppose WHO didn’t mean it to sound like a target to be aimed for, but we seem to be rising to the challenge in any case.


Hey, I agree that depression can be over-diagnosed - but it is also under-diagnosed. I agree that people can be overly medicated for depressed mood (as opposed to actual depression). I agree that there is evidence that psychotherapy and CBT works.

But if the nutcase who wrote the article actually spent some time sitting in a psychiatric ward with some patients instead of reading the DSM from beginning to end and scoffing at it non-stop (and by-the-by, I agree that some of the disorders listed in the DSM borders on defining everyone as abnormal), maybe she'll see that you can never use blanket terms in medicine, and that SSRIs are used because they actually work, not because the "Big Pharma" made up the data.

I remember a lady suffering from terrible anxiety disorder, sitting in her chair quivering non-stop like she had too much caffeine. A week later, after a few ECT sessions, the change was remarkable. She managed to smile. She was sitting at ease. She could hold a conversation looking at us in the eye.

Sit in a room with a severely depressed patient whose countenance never cracks, who stares listlessly at the ground and barely raises the energy to whisper answers to questions...and tell me that their depression is imagined.

Overdiagnosis and overtreatment is a problem with any medical condition, but it is a danger to present the argument without a balanced view, especially with mental health still being a relative taboo in our society.

psyche

9 Jul 2011 12:12 am
mayoraasei: (Geek)
On a random note, the ill-fated story of Eros and Psyche was one of my favourites out of the Greek mythology. There is something really sweet about the god of love falling in love himself (and then having his mother come in and ruin everything).

The Dorothy Dunnett book I was hoping to buy at the 2nd hand book stall in our weekly fair is gone, but I did spot Victor Kelleher's Del-Del, one of the most memorably creepy books I read in high school, but not in the Goosebumps way.

It's about a family whose middle child had recently died of leukaemia. The youngest son - the sibling closest to the child - begins to behave strangely on the first anniversary of her death, and says that he is someone else, called "Del-Del".

As with most of Kelleher's books there's a big twist in the end, and I think this is probably the best twist he's done. I wasn't at all impressed with Parklands, for example.

I remember a lecturer discussing psychiatry in fiction, and though he listed an Isobelle Carmody short story as an example, this book is always the first that comes to mind for me. It was creepy not because it was surreal or supernatural, but that you never knew what was real and whether anything was real, and I think the hanging cloud of dread, of rationality falling away to something that was either alien or insane, was a terrifying thing to confront in a family member. The sense of dread never really clears by the end of the book. There's a sense that the beast had gone to roost but the portal remains open.

Woman tries to cure her PTSD with simulated rape

Without knowing more about this case, I really shouldn't comment. I hope she really had more prolonged contact with the victim and she didn't get PTSD just from the victim screaming at the rapists =___= But I don't know if it's the tone of the article or what, it sounds more like a decadent re-enactment of a rape fantasy than an attempt to adjust to an illness =___= I'm glad they added that psychiatrists really do not recommend her method.



In celebration of SPEC movie and special being announced (and Kimoto's brief return to BOSS?), I have added an Erika icon. Alright, the real reason I'm saying anything is because she looks unrecognisable as herself >__>;;;

ho-hum

5 Jul 2011 11:10 pm
mayoraasei: There is no such thing as coincidence (Default)
You know that horrible feeling you get where you're perpetually stepping forward but contrary to logic the world around you isn't moving and you're just plunkering on in the same spot and you're getting exhausted but when you stop you realise you're still at the same place?

...Or maybe like Sisyphus but instead the summit is still a distant sparkle and you can't stop lest the boulder starts rolling backwards and crush you on its descent. Or something like that.

Anyway, aside from the boulder of impending doom looming constantly like an ominous and vaguely stalkerish storm cloud, I've actually really enjoyed my med terms, which is a vast improvement on last year. Vascular surgery was always so long but there were quite a few interesting cases I had only heard theoretically about but never watched, like open carotid endarterectomy and AAA stenting and varicose veins stripping (really creepy the first time LOL)

Infectious diseases is also really interesting. I've always loved microbiology, and ID is turning out to be a remarkably diverse learning experience. The range of conditions and the complexity of the patients are amazing, and I think I also like the aspect of meeting with very challenging cases but being able to focus on just one aspect of their overall health and manage it. It's probably one of the few medical specialties that focus on getting patients better or cured in a short space of time (unless you're talking about recurrent or chronic infections, then you're in for the long haul). I'm also picking up a lot of antibiotic names, and I can finally differentiate (some) fluroquinolones from (some) aminoglycosides, for example >_>;

A month ago while I was making cake I accidentally caught my finger in a drawer. I was so busy doing the C & E of the R.I.C.E. in order to stop the blood from dripping all over my hand that before I knew what happened my aunt slapped a slob of fresh ash (from burned paper) on the wound. Apparently there is a theory in Chinese medicine - "blood stops when it meets black".

It worked a treat: as I mentioned before the blood was oozing bad enough to trail down my hand, but after the ash went on, even after several hours there was only a small spot of blood on the bandaid I put over it. But then I completely freaked out when, after washing the finger, I realised the ash was not coming off and was completely adherent to the wound ||||||||Orz

Another time I might have taken my aunt's word that it would come off in time, but I had the misfortunate experience of accidentally pricking myself with a pacer 20 years ago and to this day the (graphite) lead that broke off under my skin is still there as an off-colour "mole". It didn't help that no amount of scrubbing or soap would make the pitch black patch even budge. And that the black patch covered half the surface area of all the visible skin between my D.I.P. joint and my nail Orz

Anyway, to cut the long woeful tale short, the whole thing eventually vanished one day, just before the wound itself actually scarred over. Nevertheless, not an experiment I wish repeated unless on a much less visible area ==; It was surprisingly effective actually, because with the ash covering the wound was completely dry, but if I picked the ash off then it would immediately start oozing.

We had a meeting of The Big Bosses today. It's one of those sessions when you realise, in a pinch, who really makes an effort to understand the students whose interests they supposedly foster and represent. My fondness for a number of supervisors has just increased that much more *___* Thank you for acknolwedging people have - and have the right to have - lives and livelihoods outside med.
mayoraasei: (Reflective)
By some miracle of divine intervention, I passed my O&G exams. I never ended up looking through the lecture notes, although in defence of my self-preservation instincts, I did read my O&G book cover-to-cover within 2 days...which is either a reflection of my speed-reading skills or...something else.

So I'm technically on break now, which means I am immediately swamped with demands on the perceived free time (especially from parents). Sometimes...well, okay, all the time you'll hear medical students whine about wanting a break, but inertia is one of those horrible things that enacts a force not only physically, but psychologically. The effort of starting up again and dragging your feet out of the mud is so much more than the effort of keeping steam and eyes forward.

Vaguely depressing reflections aside, I managed to catch up on two movies I had always intended to see, which is very productive XD

Tangled was every bit as light-hearted as I hoped it would be. The characters didn't grow on my very much though, and I felt curiously sympathetic towards the evil woman who imprisoned Rapunzel. A woman that smart and manipulative deserves to be queen XD I did like the two non-talking animal sidekicks, who brings a freshness to the comedy. That said, they're not the first non-talking animal sidekicks in a long while, so it's not like Disney is doing anything new. AND (I'm sorry, Disney fans have been getting on my nerves of late) Disney practically invented the annoying talking animal sidekicks trope, so much so that Dreamworks satirised it, so there's no use getting on a high horse about it either way.

After that I decided to choose something somewhat of a classic. Or something somewhat of a defining movie for the Brangelina brand. Unfortunately Mr and Mrs Smith turned out to be excruciatingly slow and mind-numbing, IDGI. And the plot, what plot? It's even worse than Thor *facepalm* I seriously don't get what the movie was trying to do, but in any case it produced a relationship of two very photogenic megastars and a whole hockey team of children and endless magazine fodder, so some good came out of it *rolls eyes*
mayoraasei: There is no such thing as coincidence (Default)
Can you skip class today?

Observe the conflict between "We're not talking about an 8am class here, are we?" and "Are you trying to become a doctor? I don't want you to accidentally kill me some day because you skipped this class."

Whoever wrote it obviously has no idea that 8am starts are not just the norm...but practically a luxury if you live on campus. LOL.

Now I am tempted to skip the 8am ward rounds tomorrow...lalala........
mayoraasei: There is no such thing as coincidence (Default)
These days, every time I get a chance, I measure my blood pressure, mostly to amuse myself and at other times to freak out whoever is measuring me XDDD

I reached a record low today! Of 88/61! LOL ("Normal" = 120/80) I think at one point I managed to get a reading of 58 for diastolic XDDDDD

Yes I'm still walking around and I haven't fainted yet BWAHAHAHA

I'm not actually anaemic at the moment because no conjunctival pallor XD

But I always use my low BP as my excuse for being terribly snappy in the mornings, even though I don't think it has anything to do with anything LOL

On the way to class(?) every morning I walk past a car dealer, and at 8am every day they have EVERY ONE of their cars' engines turned on and running and walking that 20 metres is like walking through an area of toxic contamination. It's giving my inner Greenie the total shizz, not to mention my inner health freak.

Someone needs to picket D=
mayoraasei: There is no such thing as coincidence (Default)
Wah wah I'm a medical student

I began reading it expecting I would agree, except I cannot.

Yes sure, I've done my share of whining about unreasonable doctors, but hey, everyone's allowed a bitch, right?

I just think if you're a medical student you have to come to terms with the fact that you chose this profession, with all its self-indulgent and obsessive-compulsive personalities, and no wonder you're going to get chewed to bits while they can grind you into the ground.

And frankly, in any profession with a mix of competitive personalities like that and under that amount of daily stress, you'd get treated like dirt at the bottom of the food chain.

I don't understand the medical student/intern whinge about paperwork. Every profession starts at the bottom of the chain doing the most mundane and nasty of jobs, and works up. I don't see why the medical profession thinks it could be exempt from this.

Yes, 40 years ago people graduated and actually GOT TO DO STUFF, like MEDICAL STUFF. But instead of complaining about the people who are just as locked into the system as you will be, why not hassle the beaurocrats and THE BLOODY LAWYERS who turned the health system this way? After all, it's because of the fear of people in black suits that they've introduced enough paperwork to continually deplete an entire forest (seriously...stuff like sending a copy of every pathology result and discharge letter both by post and by fax just gets the shizz on my inner Greenie, all because of that one patient out of whatever-thousand for whom you might miss the results and end up with a court case on your hands. LIFE WOULD BE BETTER WITHOUT BLOODY LAWYERS. The end.)
mayoraasei: There is no such thing as coincidence (Default)
So anyway, saw another cat today, and at first it was a little scared, but after I patted it, it ran up and stuck to my legs and kept rubbing its head and I was like "NOOO" and then it ran away. But it kept loitering about and it was so sweet-tempered even when I pulled its tail a few times. LOL. And then the toddler who stood there watching us sprayed pee out of his nappies. It was like those fountains. He looked like such a cherub.

The weather here has turned glorious again. I realised I could see the ocean from my toilet HAHA. It looks pretty boring, I do not understand why people want plain waterviews. The doctors here are fully old-school. They're probably the ones who can pat themselves on the back knowing they've spent their live being real doctors...and I actually don't mean that in a sarcastic sense. I think us measly medical students can only aspire to doing anywhere near half the stuff they've done in their lifetime.

In old news, I think I came to terms with my harddisk dying...which means I lost pretty much all of my writing, especially the ones I haven't sent around to people...namely the bits that tells me what I'm supposed to write next Orz Thank god I've managed to get what I have sent around back from people T-T

I think the latest chapter/edition of Next Assignment is gone forever. So are those Fealty prequel and sequel I started on. I actually had the whole sequel all planned out, and it's now gone. GONE! It's gone from my head too, so I actually do need them Orz

Fortunately I had copied out all of Vivant's story, but there was one and a half chapters I wrote back in year 11 or something about Vivant that may or may not exist on another computer =/

And the story I started in year 8...the one that predated everything...I don't know if I still have an electronic copy of it, although I do have the printed version, which must have sacrificed at least a small bush >_>;;;;

...I can't even begin to remember how many drawings I must have lost T___T I do not have backups for those TT___TT
mayoraasei: There is no such thing as coincidence (Default)
So umm...somehow, I think I passed my exams? LOL

Maybe it's the wonders of scaling, because this year's med and surgical exams were pretty full on. Almost no one walked out early in surgical (compared to only 15 people still in their seats after psych, and only because they were too lazy to move XDDD) I actually thought the surgical slightly easier than the med because although the questions were hard (eg. you had to know your contraindications and indications for each procedure, or likely symptoms and signs for each disease - and as always, they never give you enough information), if you took your time and worked through it logically you could narrow it down, whereas med was direct recall of some minor detail receptor pathway that surely you'd never need to ever remember again unless you work in pharmacology ==;;;;;;;;;;

Psych was evil. I never knew you were allowed to test history in a med school exam LOL. Cartesian dualism...basis of moral management...etc Orz Little wonder people walked out early since there's no point sitting there double-guessing yourself.

But I should really stop this bad habit of starting to study for a major exam one week before it |||||Orz

But my mid-term memory is weeaally baaad =( I function better on short-term memory LOL

It makes me feel bad that other people started studying 4 months ago Orz

Well, the next term starts Monday. At least this one doesn't have an exam at the end, but it does, apparently, have 20394 assignments. Back to the grind again....
mayoraasei: There is no such thing as coincidence (Default)
Am sitting up in the med library at uni. Haven't been here in so long...and at least holidays makes it a quiet place (i.e. there are actually free computers and no noisy pharmacy students). You know we hate you guys, pharmacy students, but you can gloat knowing that once you get your registration you'll know more about ADRs and drug names than we'll ever do in our lives...LOL.

The only reason I dragged myself out of bed at 8:30am this morning was because our med soc book shop is closing down =( They're holding a 30% discount sale and today's only the second day of the sale, but med students being OCD/competitive/cheap/enthusiastic/whatever, by the time I got to the store (which only had one other browser) there was only about 25% of the shop left =0=;;;;;;;;

Damn you, first and second years! *Shakes fist*

I ended up getting $200+ worth of books anyway ==;;;;;;; My consolation is that I'll probably not be able to buy another textbook in a long time...and if/when I do, I'll hopefully have a PDA and get the electronic version instead.

In other news, I got my formal psych exam results yesterday. I passed! By a lot more than I expected! LOL. Well okay, to be fair, our "pass" mark is about 62%, but I haven't seen a score over 70 in so long TT____TT I was surprised at my addiction medicine scores...considering we were told "drug and alcohol is hard...most students fail on that". But full marks? XDDDDD Maybe we just got the easy questions this round LOL. Unhappily this means I lost all my marks (still a whole lot) in the psych section =__= Bloody...clozapine receptors =@

On the other hand, it proved that it is possible to pass psychiatry by turning up to a grand total of 0 lectures..................*hides*

I finally got around to my backlog of pictures I need to colour. The uni computer is also LCD so that doesn't help things, but he's looking a lot yellower than I remember him looking on my laptop...uggghh. That means I should just colour everything with a red tint in the future to save myself the trouble of changing it later.

Click to follow me

Okay~~~~ Off to meet Irene......with 2kg of med textbooks in tow TT___TT
mayoraasei: There is no such thing as coincidence (Default)
Passing a long case with "a complex thought disordered patient" = WIN
Forgetting to get signed off as "satisfactory" on the assessment form = FAIL

*Headwall*

Hope he's in tomorrow. LOL.

Spent the last 4 days doing nothing but cram (and also drooling over that Windows phone 7....drooool....I really need a phoneeeee) so I'm really over it, even though I know I still haven't remembered everything about detoxing benzos/alcohol/opioids/marijuana/smoking......etc.

Speaking of Windows phone, apparently this is the fictional target audience: "a 38 year-old couple named Anna and Miles...who need to get work done on their phones but still want to play games and don't want to fiddle around with settings".

......I'm 24 going on 38 =v= I am so falling in that target group. LOL.

Incidentally I think the first omens(LOL) of my intense dislike of Apple came from its original marketing campaign for iPods, putting them as "THE hip thing to have if you're gen X and Y". The cliche is if you call yourself hip you're clearly not hip, and at the time the iPod is seriously...not hip. It was a BRICK compared to the other MP3s available on the market (iRiver and Sony all did some really gorgeous ones), but people are sheep and the fad started and Apple got rich and then the devices actually pulled ahead of its competitors.

It is elsewhere seen in the Twitlight Phenomenon...not that Twitlight is going to pull ahead of anything any time soon, except maybe snagging all the Razzie awards.
mayoraasei: There is no such thing as coincidence (Default)
Catching up on some missed lectures earlier this term...

One of the lecturers used the examples of Ragmar and William from Green Monkey Dreams as being a fictional portrayal of psychotic illnesssssssss noooooooooooooooooooooooooooo.....................!!!!!!!!!!!!!!!

I'm sure that's not Carmody's full intention at all.

I don't know if it's appropriate to put psychiatric diagnoses on a story that's supposed to be half-fantasy. Yes...in psychiatric terms it would be a strong case of delusions, particularly with William who insisted that Ragmar was a reincarnated queen from some fantasy world and he was her protector. And you might even call it a folie a trois once Ragmar's boyfriend started believing them.

But there was something beautiful about that s

tory (and Carmody's other stories based in our world - like The Gathering) there's always that haunting doubt that the whole thing treads between "delusions" and an invasion of reality, between outsiders who are unable to see the truth will label everyone mentally ill - and insiders who are unable to see that they have reflected their delusions onto their environment and created meaning out of things that's not there (very typical psychotic symptoms).

I vaguely remember Carmody did mention psychiatric illness as a background for some of the characters, but I think it was meant to highlight the point that there are some things that science cannot reach or try to understand, and that was the beauty in the story. To call that an irresponsible portrayal of psychiatric illness is...reinforcing Carmody's point =___=;;;;;;;;


OMG ARE YOU SERIOUS THE NEXT OBERNEWTYN BOOK IS THE FINAL ONE?????????????????????? How many years has it taken her???????? I WANNA SEE MATTHEWWWWW TT_____TT

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mayoraasei: There is no such thing as coincidence (Default)
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